Management of High-Grade Spondylolisthesis Including Reduction Techniques

Richard Assaker*, Scott C. Wagner, Harry L. Shufflebarger, Ronald A. Lehman

*Corresponding author for this work

Research output: Chapter in Book/Report/Conference proceedingChapterpeer-review


There exists significant controversy in the literature regarding the surgical treatment of high-grade spondylolisthesis: in situ fusion versus reduction, the timing of surgery, and the techniques for achieving fixation are highly varied. High-grade spondylolisthesis is a complicated, three-dimensional deformity with complex pathomechanics and secondary anatomic changes that develop over time. While the classification schemes and management modalities of high-grade spondylolisthesis continue to evolve with our understanding of these deformities, there is general agreement that surgical treatment of high-grade, unbalanced spondylolisthesis is the management of choice. While reduction and fixation of these high-grade slips are historically fraught with complications, including nerve injury and loss of fixation, in situ fusion is also not without reportedly severe complications. However, in the authors’ varied, multi-year experience, anatomic reduction with interbody fusion and posterior instrumentation has yielded excellent results with a relatively low complication rate.

Original languageEnglish
Title of host publicationSpondylolisthesis
Subtitle of host publicationDiagnosis, Non-Surgical Management, and Surgical Techniques: Second Edition
PublisherSpringer International Publishing
Number of pages12
ISBN (Electronic)9783031272530
ISBN (Print)9783031272523
StatePublished - 1 Jan 2023
Externally publishedYes


  • Anatomic reduction
  • High-grade spondylolisthesis
  • Lumbosacral deformity
  • Posterior instrumentation
  • Spondyloptosis
  • Surgical technique


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